Organization
DIETRICH & ASSOCIATES ORAL AND MAXILLOFACIAL SURGERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JOSEPH DIETRICH DDS, MD (OWNER/PRESIDENT)
(330) 494-6653
Entity
Organization
Contact information
Practice address
4774 MUNSON ST NW, SUITE 102, CANTON, OH 44718
(330) 494-6653
(330) 494-6630
Mailing address
4774 MUNSON ST NW, SUITE 102, CANTON, OH 44718
(330) 494-6653
(330) 494-6630
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
21924
OH
Other
Enumeration date
10/04/2006
Last updated
01/24/2020
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